Quote Request Form for Management System Certification

Please indicate the management system standard(s) required

Quality, Environment & Safety ICT and Information Security Food & Feed
ISO 9001 ISO 22301* FAMI-QS Code of Practice*

ISO 14001 ISO/IEC 20000* ISO 22000*

OHSAS 18001 ISO/IEC 27001* FSSC 22000*

ISO 50001* TickITplus* HACCP*

ISO 28001* GMP+ FSA*

TAPA *For this scheme some additional scheme specific information might be requested.

Please complete your general company information

Company name (legal entity name) >
Parent company name (if applicable) >
Office address >
Postal address >
Invoicing address >
Contact person >
Position >
Telephone >
E-mail address >
Web-site address >
NO
Did you use consultancy related to the management system?
YES - please specify below

Consultancy company name >

Name of the consultant >
Extend and work performed >

Please describe the products, activities and/or services of your company:

>

Are there any significant aspects related to the process and NO

operations (in relation with the requested scheme)? YES - please specify below

Significant aspects >

Are there any specific (relevant) legal obligations related to NO
the process and operations applicable for the organisation
YES - please specify below
(related to the requested scheme)?
Specific (relevant) legal obligations >

Please describe the desired scope of certification:

>

DNV GL BA QRF rev.2 (April 2015) Page 1-5

Are you subcontracting/outsourcing any of the activities NO
within the scope of certification? YES - please specify below

Overview of subcontracted activities >

NO
Does the system cover offsite activities?
YES - please specify below
Overview of the activities, location and
duration of the projects and number of >
worker/employees involved
Is a part of your management system currently certified? NO
activities? YES - please specify below
Management system standard >
Certification body >
Certificate expire date >

NO
YES - for the follow ing standards:
Did you set up an integrated Quality / Environmental and/or
ISO 9001
Safety management system?
ISO 14001
OHSAS 18001
In case of an integrated audit needs to be performed (audit on two or more management system
standards) please indicate the level/extend of integration of the management system:
Management Reviews consider the overall business strategy and
YES NO
plans
Integrated approach to internal audits YES NO
Integrated approach to policy and objectives YES NO
Integrated approach to systems processes YES NO
Integrated documentation set including work instructions, to a good
YES NO
level of development as appropriate
Integrated approach to improvement mechanisms (corrective and
YES NO
preventive action; measurement and continual improvement)
Integrated approach to planning, with good use of business wide
YES NO
risk management approaches
Unified management support and responsibilities YES NO

Please complete the site specific information of the head office

Company name (legal entity name) >
Office address >
City > Country >
Activities performed on this site >
Total # Employees not working in shifts >
Total # Employees working in shifts > Total # shifts >
Total # Part time employees > Working % >
Total # Non-permanent personnel* > Working days per year >
Seasonal used in QCT
*average amount of temporary, sub-contractors and contracted personnel present on the premises
If shifts are applicable please indicate the details for each shift below:
Shift 1 Start time shift > End time shift >
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)
Shift 2 Start time shift > End time shift >
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)

DNV GL BA QRF rev.2 (April 2015) Page 2-5

Shift 3 Start time shift > End time shift >
(add more if needed)
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)
NO
Are other sites/locations to be covered in the certification?
YES - please complet the table below per site

Site 1 information
Company name (legal entity name) >
Office address >
City > Country >
Activities performed on this site >
Total # Employees not working in shifts >
Total # Employees working in shifts > Total # shifts >
Total # Part time employees > Working % >
Total # Non-permanent personnel* > Working days per year >
Seasonal used in QCT
*average amount of temporary, sub-contractors and contracted personnel present on the premises
If shifts are applicable please indicate the details for each shift below:
Shift 1 Start time shift > End time shift >
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)
Shift 2 Start time shift > End time shift >
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)
Shift 3 Start time shift > End time shift >
(add more if needed)
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)

Site 2 information
Company name (legal entity name) >
Office address >
City > Country >
Activities performed on this site >
Total # Employees not working in shifts >
Total # Employees working in shifts > Total # shifts >
Total # Part time employees > Working % >
Total # Non-permanent personnel* > Working days per year >
Seasonal used in QCT
*average amount of temporary, sub-contractors and contracted personnel present on the premises
If shifts are applicable please indicate the details for each shift below:
Shift 1 Start time shift > End time shift >
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)
Shift 2 Start time shift > End time shift >
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)
Shift 3 Start time shift > End time shift >
(add more if needed)
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)

DNV GL BA QRF rev.2 (April 2015) Page 3-5

Site 3 information
Company name (legal entity name) >
Office address >
City > Country >
Activities performed on this site >
Total # Employees not working in shifts >
Total # Employees working in shifts > Total # shifts >
Total # Part time employees > Working % >
Total # Non-permanent personnel* > Working days per year >
Seasonal used in QCT
*average amount of temporary, sub-contractors and contracted personnel present on the premises
If shifts are applicable please indicate the details for each shift below:
Shift 1 Start time shift > End time shift >
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)
Shift 2 Start time shift > End time shift >
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)
Shift 3 Start time shift > End time shift >
(add more if needed)
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)

Site 4 information (add more tables if needed)

Company name (legal entity name) >
Office address >
City > Country >
Activities performed on this site >
Total # Employees not working in shifts >
Total # Employees working in shifts > Total # shifts >
Total # Part time employees > Working % >
Total # Non-permanent personnel* > Working days per year >
Seasonal used in QCT
*average amount of temporary, sub-contractors and contracted personnel present on the premises
If shifts are applicable please indicate the details for each shift below:
Shift 1 Start time shift > End time shift >
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)
Shift 2 Start time shift > End time shift >
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)
Shift 3 Start time shift > End time shift >
(add more if needed)
Key shift activities >
Describe level of control for the shifts >
(based e.g. on internal audits, Quality Control)

DNV GL BA QRF rev.2 (April 2015) Page 4-5

4 For ISO 50001 Please specify:

Main energy aspects

Estimated total consumption of electricity and/or heat and main energy consuming installations/processes (building
ventilation, building heating/cooling, specific processes/machines etc.)

Any specific regulatory requirements related to energy

Installations within the boundary of scope, but where processes/activities affecting energy are outsourced (e.g.
incinerator plant owned by company, but operations are outsourced to another company)

Any (national) program that the company subscribes to (e.g. voluntary energy efficiency programs, like the Swedish
PFE program)

DNV GL BA QRF rev.2 (April 2015) Page 5-5